<div class="panel">
    <div class="panel-heading"><?php echo _trans('title.private_tutoring_form'); ?></div>
    <div class="panel-body">
        <form role="form" action="" method="POST" id="frm-private-tuition">
            <div class="form-group">
                <label for="tuition-name"><?php echo _trans('tuition.title.name'); ?></label>
                <input id="tuition-name" name="tuition[name]" type="text" class="form-control"/>
            </div>
            <div class="form-group">
                <label for="tuition-email"><?php echo _trans('tuition.title.email'); ?></label>
                <input id="tuition-email" name="tuition[email]" type="text" class="form-control"/>
            </div>
            <div class="form-group">
            <label for="tuition-telephone"><?php echo _trans('tuition.title.telephone'); ?></label>
                <input id="tuition-telephone" name="tuition[telephone]" type="text" class="form-control"/>
            </div>
            <div class="form-group">
                <label for="tuition-duration"><?php echo _trans('tuition.title.duration'); ?></label>
                <textarea id="tuition-duration" name="tuition[duration]" class="form-control"></textarea>
            </div>
            <div class="form-group">
                <label for="tuition-datetime"><?php echo _trans('tuition.title.date'); ?></label>
                <input id="tuition-datetime" name="tuition[date-time]" type="text" class="form-control"/>
            </div>
            <div class="form-group">
                <label for="tuition-venue"><?php echo _trans('tuition.title.venue'); ?></label>
                <input id="tuition-venue" name="tuition[venue]" type="text" class="form-control"/>
            </div>
            <div class="form-group">
                <label for="tuition-firstlanguage"><?php echo _trans('tuition.title.first_lang'); ?></label>
                <input id="tuition-firstlanguage" name="tuition[first-language]" type="text" class="form-control"/>
            </div>
            <div class="form-group">
                <label for="tuition-other-languages"><?php echo _trans('tuition.title.other_lang'); ?></label>
                <input id="tuition-other-languages" name="tuition[other-languages]" type="text" class="form-control"/>
            </div>
            <div class="form-group">
                <label for="tuition-other-educationalqualify"><?php echo _trans('tuition.title.highest_edu_qual'); ?></label>
                <input id="tuition-other-educationalqualify" name="tuition[other-educationalqualify]" type="text" class="form-control"/>
            </div>
            <div class="form-group">
                <label for="tuition-current-employment"><?php echo _trans('tuition.title.currrent_employ'); ?></label>
                <input id="tuition-current-employment" name="tuition[current-employment]" type="text" class="form-control"/>
            </div>
            <div class="form-group">
                <label for="tuition-area"><?php echo _trans('tuition.title.focus'); ?> ?</label>
                <textarea id="tuition-area" name="tuition[area-focus]" class="form-control"></textarea>
            </div>
            <div class="form-group">
                <label for="tuition-other-info"><?php echo _trans('tuition.title.tell'); ?> ?</label>
                <textarea id="tuition-other-info" name="tuition[other-info]" class="form-control"></textarea>
            </div>
            <br/>
            <button type="button" action="private-tuition" id="btn-private-tuition" class="btn btn-primary pull-right">
                <i class="glyphicon glyphicon-ok-sign"></i>
                <?php echo _trans('title.submit'); ?>
            </button>
            <div class="clearfix"></div>
        </form>
    </div>
</div>